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Psychological risk and protective factors associated with depressive symptoms among adolescents in secondary schools in China: A systematic review and meta-analysis

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  • Tang, Xinfeng
  • Tang, Suqin
  • Ren, Zhihong
  • Wong, Daniel Fu Keung

Abstract

Depressive symptoms are prevalent among adolescents in Chinese secondary schools. The aim of the meta-analysis is to provide an overall estimate of psychological risk/protective factors associated with depressive symptoms among this population. English and Chinese databases were searched. Journal articles and theses which reported at least one risk/protective factor for depressive symptoms among secondary school students in mainland China were included for screening. The Newcastle–Ottawa Scale (NOS) adapted for cross-sectional studies was used to rate the quality of each study. A random effects model was used to combine the effect sizes. Twenty-one psychological factors were identified in a total of 140 articles. The absolute values of the effect sizes ranged from 0.08 to 0.63. Among them, automatic thoughts (r = 0.63), negative self-evaluation (r = 0.57), neuroticism (r = 0.57), self-esteem (r = −0.53) and resilience (r = −0.50) were associated with depressive symptoms with large effect sizes. Further analysis revealed that study quality, sample size and publication year were significant moderators of certain associations. However, grade, mean age and gender were not significant moderators. The limitations of the meta-analysis included unexplained large heterogeneity, significant publication bias, and inability to investigate the interactions of different factors and to determine the direction of causal relationships between them and depression. The study suggests that several cognitive factors, personality traits and coping strategies have strong correlations with depressive symptoms among Chinese adolescents. Further research is required to identify specific strategies to target these risk factors and to develop effective prevention and treatment programs.

Suggested Citation

  • Tang, Xinfeng & Tang, Suqin & Ren, Zhihong & Wong, Daniel Fu Keung, 2020. "Psychological risk and protective factors associated with depressive symptoms among adolescents in secondary schools in China: A systematic review and meta-analysis," Children and Youth Services Review, Elsevier, vol. 108(C).
    • Handle: RePEc:eee:cysrev:v:108:y:2020:i:c:s0190740919312381
    DOI: 10.1016/j.childyouth.2019.104680
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    References listed on IDEAS

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    1. Sue Duval & Richard Tweedie, 2000. "Trim and Fill: A Simple Funnel-Plot–Based Method of Testing and Adjusting for Publication Bias in Meta-Analysis," Biometrics, The International Biometric Society, vol. 56(2), pages 455-463, June.
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    Cited by:

    1. Qiongwen Zhang & Daniel T. L. Shek & Yangu Pan, 2021. "Parent-Child Discrepancies in Perceived Parent-Child Communication and Depressive Symptoms in Early Adolescents in China," IJERPH, MDPI, vol. 18(22), pages 1-17, November.
    2. Piotr Długosz & Damian Liszka & Luydmila Yuzva, 2022. "The Link between Subjective Religiosity, Social Support, and Mental Health among Young Students in Eastern Europe during the COVID-19 Pandemic: A Cross-Sectional Study of Poland and Ukraine," IJERPH, MDPI, vol. 19(11), pages 1-14, May.
    3. Man-Man Peng & Jianli Xing & Xinfeng Tang & Qinglu Wu & Dannuo Wei & Mao-Sheng Ran, 2022. "Disease-Related Risk Factors for Caregiver Burden among Family Caregivers of Persons with Schizophrenia: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 19(3), pages 1-16, February.
    4. Chen, Runting & Huang, Yueyi & Yu, Meng, 2021. "The latent profile analysis of Chinese adolescents’ depression: Examination and validation," Children and Youth Services Review, Elsevier, vol. 125(C).

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